Doctor Name: | MARTHA SHERRILL |
NPI Number: | 1710369533 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 146.008935 |
Business Practice Address: | 713 W Church St Apt 8 Champaign, IL - 618203360 |
Business Phone Number: | 9856881923 |
Business Fax Number: | |
Mailing Address: | 306 W Maple St, Apt B CHAMPAIGN |
State: | IL |
Postal Code: | 618202955 |
Phone Number: | 9856881923 |
Fax Number: | |
NPI Enumeration Date: | 06/29/2015 |
NPI Last Update Date: | 11/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 146.008935 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |